Drugs online research references
J Cardiovasc Pharmacol. 1989;13 Suppl 3:S49-51.
Pharmacokinetic and pharmacodynamic properties of ramipril in patients with congestive heart failure (NYHA III-IV).
Gerckens U, Grube E, Mengden T, Sigel H, Wagner WL, Lahn T, Irmisch R, Metzger H.
Departement of Cardiology, Siegburg General Hospital, F.R.G.
To investigate the pharmacokinetics and pharmacodynamics of a new angiotensin converting enzyme (ACE) inhibitor, ramipril (HOE 498), in patients with cardiac insufficiency (NYHA III-IV), we performed an open trial with a follow-up of 10 days. Twenty-seven patients (18 females, 9 males), mean aged 62 years (46-83) with severe heart failure, were included. After a single oral dose of 5 mg ramipril, the plasma and urine levels of ramipril, ramiprilat, ACE plasma activity, standard laboratory values, blood pressure and pulse rate were evaluated. The maximal plasma level of ramipril was 57.0 +/- 26.8 ng/ml after 1.4 h; t1/2 was 2.4 +/- 1.2 h. The peak level of ramiprilat was 27.9 +/- 24 ng/ml after 4.6 h; t1/2 for the active compound was 6 +/- 4.2 h. The total recovery of ramipril and metabolites in urine was on average 39 +/- 17.5% within 96 h. Ninety-five percent inhibition of ACE activity was observed in all patients and 80% inhibition lasted 24 h. Systolic and diastolic blood pressure decreased without changes in heart rate. Five patients had mild side effects: hypotension, diarrhea, and dizziness. In conclusion, in patients with severe heart failure, plasma levels of drug and active metabolite were higher and remained measurable longer, with more sustained inhibition of ACE activity than reported in healthy volunteers. This indicates that titration should start with lower doses (1.25-2.5 mg) and that doses above 5 mg may rarely be necessary.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2474102&dopt=Abstract
Immunopharmacology. 1996 Jun;33(1-3):305-7.
Pressor action of angiotensin I at the ventrolateral medulla: effect of selective angiotensin blockade.
Lima DX, Fontes MA, Oliveira RC, Campagnole-Santos MJ, Khosla MC, Santos RA.
Departamento de Fisiologia and Biofisica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
In this study we explored the possibility that angiotensin-(1-7) (Ang-(1-7)) is involved in the control of blood pressure at the rostral ventrolateral medulla (RVLM) by determining the effect of angiotensin antagonists (DuP 753 and A-779) and the effect of the angiotensin converting enzyme inhibitor, ramiprilat on the pressor action produced by angiotensin I (Ang I). The pressor effect produced by bilateral microinjection of Ang I into the RVLM of anesthetized rats was not significantly altered by DuP 753 or by the ACE inhibitor ramiprilat. Conversely, the Ang-(1-7) antagonist, A-779, reduced significantly the pressor effect produced by Ang I. These data suggest that in our experimental condition Ang I was preferentially converted to Ang-(1-7) at RVLM, or that Ang I and/or one of its fragments acts through a receptor blocked by A-779.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8856170&dopt=Abstract
J Cardiovasc Pharmacol. 1993;22 Suppl 9:S36-42.
Multiple-dose pharmacokinetics of ramipril in patients with chronic congestive heart failure.
Heintz B, Verho M, Brockmeier D, Luckel G, Maigatter S, Sieberth HG, Rangoonwala B, Bender N.
2nd Medical Clinic, Technical University of Aachen, Germany.
Thirteen patients with chronic congestive heart failure of NYHA class II-III received multiple doses (14 days) of ramipril (5 mg once daily); the concentrations of ramipril and ramiprilat in plasma, as well as ramipril, ramiprilat, glucuronides, diketopiperazine, and diketopiperazine acid in urine were measured at various times for 14 days. One patient dropped out after the first day due to hypotension and another who accidentally received another ACE inhibitor additionally was excluded, so that 11 patients completed the study. Ramipril and ramiprilat in plasma were determined by radioimmunoassay, and ramipril and its metabolites in urine were measured by gas chromatography in the laboratories of Hoechst AG. Peak concentrations of the active substance ramiprilat were reached after about 4 h and amounted to 22.3 +/- 11.1 ng/ml after the first dose, and a peak concentration of 26.6 +/- 10.0 ng/ml was observed 2.5 +/- 1.4 h on average after administration on day 14. Practically no accumulation was observed for ramiprilat; the AUD (0-24 h) values increased from 191.3 +/- 83.1 ng.h/ml for the first study day to 238.3 +/- 98.0 ng.h/ml for day 14. As expected, only very small fractions of the dose were excreted with urine as unchanged ramipril and ramipril glucuronide. Ramiprilat is excreted with urine to a larger extent than is rampiril--on average 6.6 +/- 3.0% on the first day and 12.2 +/- 3.8% on day 14. The total amount excreted increased by 34% on average, and was mainly due to an increased ramiprilat excretion.(ABSTRACT TRUNCATED AT 250 WORDS)
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7514239&dopt=Abstract
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